IM 4

Question 1

Colonic obstruction

Answer 1

Neoplasm; stricture: ischemic, diverticular, inflammatory

Question 2

Anal sphincter spasm

Answer 2

Anal fissure, painful hemorrhoids

Question 3

Irritable bowel syndrome

Answer 3

Constipation-predominant, alternating meds

Question 4

Medications

Answer 4

Ca2+ blockers, antidepressants

Question 5

Colonic pseudo-obstruction

Answer 5

Slow-transit constipation, megacolon (rare Hirschsprung’s, Chagas)

Question 6

Disorders of rectal evacuation

Answer 6

Pelvic floor dysfunction; anismus; descending perineum syndrome; rectal mucosal prolapse; rectocele

Question 7

Endocrinopathies

Answer 7

Hypothyroidism, hypercalcemia, pregnancy

Question 8

Psychiatric disorders

Answer 8

Depression, eating disorders, drugs

Question 9

Neurologic disease

Answer 9

Parkinsonism, multiple sclerosis, spinal cord injury

Question 10

Generalized muscle disease

Answer 10

Progressive systemic sclerosis

Question 11

What are the recent onset causes of constipation?

Answer 11

Colonic obstruction
Anal sphincter spasm
Medications